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[MRSA infections in the neonatal unit]
1Department of Pediatrics, Teikyo University School of Medicine, Ichihara Hospital.
Summary
An epidemic of TSST-1-positive MRSA strains caused severe neonatal infections, including atypical toxic shock syndrome (TSS). Prompt exchange transfusions alongside antibiotics were crucial for treating these multiply resistant infections.
Area of Science:
- Neonatal infectious diseases
- Microbiology
- Epidemiology
Context:
- MRSA infections pose a significant threat in neonatal units.
- An epidemic of TSST-1-positive MRSA strains occurred at Teikyo University Hospital from 1988-1989.
- Previous MRSA cases were sporadic before the epidemic.
Purpose:
- To describe the experience and characteristics of a MRSA epidemic in a neonatal unit.
- To analyze the clinical manifestations and treatment outcomes of neonatal MRSA infections, particularly toxic shock syndrome (TSS).
Summary:
- An abrupt increase in MRSA-colonized and/or diseased neonates was observed in October 1988.
- The epidemic strains were TSST-1-positive, coagulase type II, and multiply resistant, including to gentamicin.
- The disease/colonization ratio was 37.0% among 108 neonates, with 5 cases of atypical TSS presenting with shock and leukopenia, often without fever or rash.
Impact:
- Highlights the severity of TSST-1-positive MRSA strains in neonates.
- Emphasizes the need for effective antibiotics and prompt exchange transfusions for treating neonatal TSS.
- Informs infection control strategies in neonatal intensive care units.